All these charts lament the high prices charged by U.S. hospitals

A former student asked me about this chart from the New York Times that highlights much higher prices of hospital procedures in the U.S. relative to a comparison group of seven countries.

The dot plot is clearly thought through. It is not a default chart that pops out of software.

Based on its design, we surmise that the designer has the following intentions:

1. The names of the medical procedures are printed to be read, thus the long text is placed horizontally.
   
   
2. The actual price is not as important as the relative price, expressed as an index with the U.S. price at 100%. These reference values are printed in glaring red, unignorable.
   
   
3. Notwithstanding the above point, the actual price is still of secondary importance, and the values are provided as a supplement to the row labels. Getting to the actual prices in the comparison countries requires further effort, and a calculator.
   
   
4. The primary comparison is between the U.S. and the rest of the world (or the group of seven countries included). It is less important to distinguish specific countries in the comparison group, and thus the non-U.S. dots are given pastels that take some effort to differentiate.
   
   
5. Probably due to reader feedback, the font size is subject to a minimum so that some labels are split into two lines to prevent the text from dominating the plotting region.

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In the Trifecta Checkup view of the world, there is no single best design. The best design depends on the intended message and what’s in the available data.

To illustate this, I will present a few variants of the above design, and discuss how these alternative designs reflect the designer's intentions.

Note that in all my charts, I expressed the relative price in terms of discounts, which is the mirror image of premiums. Instead of saying Country A's price is 80% of the U.S. price, I prefer to say Country A's price is a 20% saving (or discount) off the U.S. price.

First up is the following chart that emphasizes countries instead of hospital procedures:

This chart encourages readers to draw conclusions such as "Hospital prices are 60-80 percent cheaper in Holland relative to the U.S." But it is more taxing to compare the cost of a specific procedure across countries.

The indexing strategy already creates a barrier to understanding relative costs of a specific procedure. For example, the value for angioplasty in Australia is about 55% and in Switzerland, about 75%. The difference 75%-55% is meaningless because both numbers are relative savings from the U.S. baseline. Comparing Australia and Switzerland requires a ratio (0.75/0.55 = 1.36): Australia's prices are 36% above Swiss prices, or alternatively, Swiss prices are a 64% 26% discount off Australia's prices.

The following design takes it even further, excluding details of individual procedures:

For some readers, less is more. It’s even easier to get a rough estimate of how much cheaper prices are in the comparison countries, for now, except for two “outliers”, the chart does not display individual values.

The widths of these bars reveal that in some countries, the amount of savings depends on the specific procedures.

The bar design releases the designer from a horizontal orientation. The country labels are shorter and can be placed at the bottom in a vertical design:

It's not that one design is obviously superior to the others. Each version does some things better. A good designer recognizes the strengths and weaknesses of each design, and selects one to fulfil his/her intentions.

 

P.S. [1/3/20] Corrected a computation, explained in Ken's comment.

Marketers want millennials to know they're millennials

When I posted about the lack of a standard definition of "millennials", Dean Eckles tweeted about the arbitrary division of age into generational categories. His view is further reinforced by the following chart, courtesy of PewResearch by way of MarketingCharts.com.

Pew asked people what generation they belong to. The amount of people who fail to place themselves in the right category is remarkable. One way to interpret this finding is that these are marketing categories created by the marketing profession. We learned in my other post that even people who use the term millennial do not have a consensus definition of it. Perhaps the 8 percent of "millennials" who identify as "boomers" are handing in a protest vote!

The chart is best read row by row - the use of stacked bar charts provides a clue. Forty percent of millennials identified as millennials, which leaves sixty percent identifying as some other generation (with about 5 percent indicating "other" responses). 

While this chart is not pretty, and may confuse some readers, it actually shows a healthy degree of analytical thinking. Arranging for the row-first interpretation is a good start. The designer also realizes the importance of the diagonal entries - what proportion of each generation self-identify as a member of that generation. Dotted borders are deployed to draw eyes to the diagonal.

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The design doesn't do full justice for the analytical intelligence. Despite the use of the bar chart form, readers may be tempted to read column by column due to the color scheme. The chart doesn't have an easy column-by-column interpretation.

It's not obvious which axis has the true category and which, the self-identified category. The designer adds a hint in the sub-title to counteract this problem.

Finally, the dotted borders are no match for the differential colors. So a key message of the chart is buried.

Here is a revised chart, using a grouped bar chart format:

***

In a Trifecta checkup (link), the original chart is a Type V chart. It addresses a popular, pertinent question, and it shows mature analytical thinking but the visual design does not do full justice to the data story.

 

 

Who is a millennial? An example of handling uncertainty

I found this fascinating chart from CNBC, which attempts to nail down the definition of a millennial.

It turns out everyone defines "millennials" differently. They found 23 different definitions. Some media outlets apply different definitions in different items.

I appreciate this effort a lot. The design is thoughtful. In making this chart, the designer added the following guides:

• The text draws attention to the definition with the shortest range of birth years, and the one with the largest range.
• The dashed gray gridlines help with reading the endpoints of each bar.
• The yellow band illustrates the so-called average range. It appears that this average range is formed by taking the average of the beginning years and the average of the ending years. This indicates a desire to allow comparisons between each definition and the average range.
• The bars are ordered by the ending birth year (right edge).

The underlying issue is how to display uncertainty. The interest here is not just to feature the "average" definition of a millennial but to show the range of definitions.

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In making my chart, I apply a different way to find the "average" range. Given any year, say 1990, what is the chance that it is included in any of the definitions? In other words, what proportion of the definitions include that year? In the following chart, the darker the color, the more likely that year is included by the "average" opinion.

I ordered the bars from shortest to the longest so there is no need to annotate them. Based on this analysis, 90 percent (or higher) of the sources list 19651985 to 1993 as part of the range while 70 percent (or higher) list 19611981 to 1996 as part of the range.

 

 

The rule governing which variable to put on which axis, served a la mode

When making a scatter plot, the two variables should not be placed arbitrarily. There is a rule governing this: the outcome variable should be shown on the vertical axis (also called y-axis), and the explanatory variable on the horizontal (or x-) axis.

This chart from the archives of the Economist has this reversed:

The title of the accompanying article is "Ice Cream and IQ"...

In a Trifecta Checkup (link), it's a Type DV chart. It's preposterous to claim eating ice cream makes one smarter without more careful studies. The chart also carries the xyopia fallacy: by showing just two variables, readers are unwittingly led to explain differences in "IQ" using differences in per-capita ice-cream consumption when lots of other stronger variables will explain any gaps in IQ.

In this post, I put aside my objections to the analysis, and focus on the issue of assigning variables to axes. Notice that this chart reverses the convention: the outcome variable (IQ) is shown on the horizontal, and the explanatory variable (ice cream) is shown on the vertical.

Here is a reconstruction of the above chart, showing only the dots that were labeled with country names. I fitted a straight regression line instead of a curve. (I don't understand why the red line in the original chart bends upwards when the data for Japan, South Korea, Singapore and Hong Kong should be dragging it down.)

Note that the interpretation of the regression line raises eyebrows because the presumed causality is reversed. For each 50 points increase in PISA score (IQ), this line says to expect ice cream consumption to raise by about 1-2 liters per person per year. So higher IQ makes people eat more ice cream.

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If the convention is respected, then the following scatter plot results:

The first thing to note is that the regression analysis is different here from that shown in the previous chart. The blue regression line is not equivalent to the black regression line from the previous chart. You cannot reverse the roles of the x and y variables in a regression analysis, and so neither should you reverse the roles of the x and y variables in a scatter plot.

The blue regression line can be interpreted as having two sections, roughly, for countries consuming more than or less than 6 liters of ice cream per person per year. In the less-ice-cream countries, the correlation between ice cream and IQ is stronger (I don't endorse the causal interpretation of this statement).

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When you make a scatter plot, you have two variables for which you want to analyze their correlation. In most cases, you are exploring a cause-effect relationship.

Higher income households cares more on politics.
Less educated citizens are more likely to not register to vote.
Companies with more diverse workforce has better business performance.

Frequently, the reverse correlation does not admit a causal interpretation:

Caring more about politics does not make one richer.
Not registering to vote does not make one less educated.
Making more profits does not lead to more diversity in hiring.

In each of these examples, it's clear that one variable is the outcome, the other variable is the explanatory factor. Always put the outcome in the vertical axis, and the explanation in the horizontal axis.

The justification is scientific. If you are going to add a regression line (what Excel calls a "trendline"), you must follow this convention, otherwise, your regression analysis will yield the wrong result, with an absurd interpretation!

 

[PS. 11/3/2019: The comments below contain different theories that link the two variables, including theories that treat PISA score ("IQ") as the explanatory variable and ice cream consumption as the outcome. Also, I elaborated that the rule does not dictate which variable is the outcome - the designer effectively signals to the reader which variable is regarded as the outcome by placing it in the vertical axis.]

Pulling the multi-national story out, step by step

Reader Aleksander B. found this Economist chart difficult to understand.

Given the chart title, the reader is looking for a story about multinationals producing lower return on equity than local firms. The first item displayed indicates that multinationals out-performed local firms in the technology sector.

The pie charts on the right column provide additional information about the share of each sector by the type of firms. Is there a correlation between the share of multinationals, and their performance differential relative to local firms?

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We can clean up the presentation. The first changes include using dots in place of pipes, removing the vertical gridlines, and pushing the zero line to the background:

The horizontal gridlines attached to the zero line can also be removed:

Now, we re-order the rows. Start with the aggregate "All sectors". Then, order sectors from the largest under-performance by multinationals to the smallest.

The pie charts focus only on the share of multinationals. Taking away the remainders speeds up our perception:

Help the reader understand the data by dividing the sectors into groups, organized by the performance differential:

For what it's worth, re-sort the sectors from largest to smallest share of multinationals:

Having created groups of sectors by share of multinationals, I simplify further by showing the average pie chart within each group:

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To recap all the edits, here is an animated gif: (if it doesn't play automatically, click on it)

***

Judging from the last graphic, I am not sure there is much correlation between share of multinationals and the performance differentials. It's interesting that in aggregate, local firms and multinationals performed the same. The average hides the variability by sector: in some sectors, local firms out-performed multinationals, as the original chart title asserted.

Tennis greats at the top of their game

The following chart of world No. 1 tennis players looks pretty but the payoff of spending time to understand it isn't high enough. The light colors against the tennis net backdrop don't work as intended. The annotation is well done, and it's always neat to tug a legend inside the text.

The original is found at Tableau Public (link).

The topic of the analysis appears to be the ages at which tennis players attained world #1 ranking. Here are the male players visualized differently:

Some players like Jimmy Connors and Federer have second springs after dominating the game in their late twenties. It's relatively rare for players to get to #1 after 30.

Choosing between individuals and aggregates

Friend/reader Thomas B. alerted me to this paper that describes some of the key chart forms used by cancer researchers.

It strikes me that many of the "new" charts plot granular data at the individual level. This heatmap showing gene expressions show one column per patient:

This so-called swimmer plot shows one bar per patient:

This spider plot shows the progression of individual patients over time. Key events are marked with symbols.

These chart forms are distinguished from other ones that plot aggregated statistics: statistical averages, medians, subgroup averages, and so on.

One obvious limitation of such charts is their lack of scalability. The number of patients, the variability of the metric, and the timing of trends all drive up the amount of messiness.

I am left wondering what Question is being addressed by these plots. If we are concerned about treatment of an individual patient, then showing each line by itself would be clearer. If we are interested in the average trends of patients, then a chart that plots the overall average, or subgroup averages would be more accurate. If the interpretation of the individual's trend requires comparing with similar patients, then showing that individual's line against the subgroup average would be preferred.

When shown these charts of individual lines, readers are tempted to play the statistician - without using appropriate tools! Readers draw aggregate conclusions, performing the aggregation in their heads.

The authors of the paper note: "Spider plots only provide good visual qualitative assessment but do not allow for formal statistical inference." I agree with the second part. The first part is a fallacy - if the visual qualitative assessment is good enough, then no formal inference is necessary! The same argument is often made when people say they don't need advanced analysis because their simple analysis is "directionally accurate". When is something "directionally inaccurate"? How would one know?

Reference: Chia, Gedye, et. al., "Current and Evolving Methods to Visualize Biological Data in Cancer Research", JNCI, 2016, 108(8). (link)

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Meteoreologists, whom I featured in the previous post, also have their own spider-like chart for hurricanes. They call it a spaghetti map:

Compare this to the "cone of uncertainty" map that was featured in the prior post:

These two charts build upon the same dataset. The cone map, as we discussed, shows the range of probable paths of the storm center, based on all simulations of all acceptable models for projection. The spaghetti map shows selected individual simulations. Each line is the most likely trajectory of the storm center as predicted by a single simulation from a single model.

The problem is that each predictive model type has its own historical accuracy (known as "skill"), and so the lines embody different levels of importance. Further, it's not immediately clear if all possible lines are drawn so any reader making conclusions of, say, the envelope containing x percent of these lines is likely to be fooled. Eyeballing the "cone" that contains x percent of the lines is not trivial either. We tend to naturally drift toward aggregate statistical conclusions without the benefit of appropriate tools.

Plots of individuals should be used to address the specific problem of assessing individuals.

As Dorian confounds meteorologists, we keep our minds clear on hurricane graphics, and discover correlation as our friend

As Hurricane Dorian threatens the southeastern coast of the U.S., forecasters are fretting about the lack of consensus among various predictive models used to predict the storm’s trajectory. The uncertainty of these models, as reflected in graphical displays, has been a controversial issue in the visualization community for some time.

Let’s start by reviewing a visual design that has captured meteorologists in recent years, something known as the cone map.

If asked to explain this map, most of us trace a line through the middle of the cone understood to be the center of the storm, the “cone” as the areas near the storm center that are affected, and the warmer colors (red, orange) as indicating higher levels of impact. [Note: We will  design for this type of map circa 2000s.]

The above interpretation is complete, and feasible. Nevertheless, the data used to make the map are forward-looking, not historical. It is still possible to stick to the same interpretation by substituting historical measurement of impact with its projection. As such, the “warmer” regions are projected to suffer worse damage from the storm than the “cooler” regions (yellow).

After I replace the text that was removed from the map (see below), you may notice the color legend, which discloses that the colors on the map encode probabilities, not storm intensity. The text further explains that the chart shows the most probable path of the center of the storm – while the coloring shows the probability that the storm center will reach specific areas.

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When reading a data graphic, we rarely first look for text about how to read the chart. In the case of the cone map, those who didn’t seek out the instructions may form one of these misunderstandings:

1. For someone living in the yellow-shaded areas, the map does not say that the impact of the storm is projected to be lighter; it’s that the center of the storm has a lower chance of passing right through. If, however, the storm does pay a visit, the intensity of the winds will reach hurricane grade.
2. For someone living outside the cone, the map does not say that the storm will definitely bypass you; it’s that the chance of a direct hit is below the threshold needed to show up on the cone map. Thee threshold is set to attain 66% accurate. The actual paths of storms are expected to stay inside the cone two out of three times.

Adding to the confusion, other designers have produced cone maps in which color is encoding projections of wind speeds. Here is the one for Dorian.

This map displays essentially what we thought the first cone map was showing.

One way to differentiate the two maps is to roll time forward, and imagine what the maps should look like after the storm has passed through. In the wind-speed map (shown below right), we will see a cone of damage, with warmer colors indicating regions that experienced stronger winds.

In the storm-center map (below right), we should see a single curve, showing the exact trajectory of the center of the storm. In other words, the cone of uncertainty dissipates over time, just like the storm itself.

 

After scientists learned that readers were misinterpreting the cone maps, they started to issue warnings, and also re-designed the cone map. The cone map now comes with a black-box health warning right up top. Also, in the storm-center cone map, color is no longer used. The National Hurricane Center even made a youtube pointing out the dos and donts of using the cone map.

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The conclusion drawn from misreading the cone map isn’t as devastating as it’s made out to be. This is because the two issues are correlated. Since wind speeds are likely to be stronger nearer to the center of the storm, if one lives in a region that has a low chance of being a direct hit, then that region is also likely to experience lower average wind speeds than those nearer to the projected center of the storm’s path.

Alberto Cairo has written often about these maps, and in his upcoming book, How Charts Lie, there is a nice section addressing his work with colleagues at the University of Miami on improving public understanding of these hurricane graphics. I highly recommended Cairo’s book here.

P.S. [9/5/2019] Alberto also put out a post about the hurricane cone map.

 

 

 

Water stress served two ways

Via Alberto Cairo (whose new book How Charts Lie can be pre-ordered!), I found the Water Stress data visualization by the Washington Post. (link)

The main interest here is how they visualized the different levels of water stress across the U.S. Water stress is some metric defined by the Water Resources Institute that, to my mind, measures the demand versus supply of water. The higher the water stress, the higher the risk of experiencing droughts.

There are two ways in which the water stress data are shown: the first is a map, and the second is a bubble plot.

This project provides a great setting to compare and contrast these chart forms.

How Data are Coded

In a map, the data are usually coded as colors. Sometimes, additional details can be coded as shades, or moire patterns within the colors. But the map form locks down a number of useful dimensions - including x and y location, size and shape. The outline map reserves all these dimensions, rendering them unavailable to encode data.

By contrast, the bubble plot admits a good number of dimensions. The key ones are the x- and y- location. Then, you can also encode data in the size of the dots, the shape, and the color of the dots.

In our map example, the colors encode the water stress level, and a moire pattern encodes "arid areas". For the scatter plot, x = daily water use, y = water stress level, grouped by magnitude, color = water stress level, size = population. (Shape is constant.)

Spatial Correlation

The map is far superior in displaying spatial correlation. It's visually obvious that the southwestern states experience higher stress levels.

This spatial knowledge is relinquished when using a bubble plot. The designer relies on the knowledge of the U.S. map in the head of the readers. It is possible to code this into one of the available dimensions, e.g. one could make x = U.S. regions, but another variable is sacrificed.

Non-contiguous Spatial Patterns

When spatial patterns are contiguous, the map functions well. Sometimes, spatial patterns are disjoint. In that case, the bubble plot, which de-emphasizes the physcial locations, can be superior. In our example, the vertical axis divides the states into five groups based on their water stress levels. Try figuring out which states are "medium to high" water stress from the map, and you'll see the difference.

Finer Geographies

The map handles finer geographical units like counties and precincts better. It's completely natural.

In the bubble plot, shifting to finer units causes the number of dots to explode. This clutters up the chart. Besides, while most (we hope) Americans know the 50 states, most of us can't recite counties or precincts. Thus, the designer can't rely on knowledge in our heads. It would be impossible to learn spatial patterns from such a chart.

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The key, as always, is to nail down your message, then select the right chart form.

 

 

This Wimbledon beauty will be ageless

This Financial Times chart paints the picture of the emerging trend in Wimbledon men’s tennis: the average age of players has been rising, and hits 30 years old for the first time ever in 2019.

The chart works brilliantly. Let's look at the design decisions that contributed to its success.

The chart contains a good amount of data and the presentation is carefully layered, with the layers nicely tied to some visual cues.

Readers are drawn immediately to the average line, which conveys the key statistical finding. The blue dot  reinforces the key message, aided by the dotted line drawn at 30 years old. The single data label that shows a number also highlights the message.

Next, readers may notice the large font that is applied to selected players. This device draws attention to the human stories behind the dry data. Knowledgable fans may recall fondly when Borg, Becker and Chang burst onto the scene as teenagers.

 

Then, readers may pick up on the ticker-tape data that display the spread of ages of Wimbledon players in any given year. There is some shading involved, not clearly explained, but we surmise that it illustrates the range of ages of most of the contestants. In a sense, the range of probable ages and the average age tell the same story. The current trend of rising ages began around 2005.

 

Finally, a key data processing decision is disclosed in chart header and sub-header. The chart only plots the players who reached the fourth round (16). Like most decisions involved in data analysis, this choice has both desirable and undesirable effects. I like it because it thins out the data. The chart would have appeared more cluttered otherwise, in a negative way.

The removal of players eliminated in the early rounds limits the conclusion that one can draw from the chart. We are tempted to generalize the finding, saying that the average men’s player has increased in age – that was what I said in the first paragraph. Thinking about that for a second, I am not so sure the general statement is valid.

The overall field might have gone younger or not grown older, even as the older players assert their presence in the tournament. (This article provides side evidence that the conjecture might be true: the author looked at the average age of players in the top 100 ATP ranking versus top 1000, and learned that the average age of the top 1000 has barely shifted while the top 100 players have definitely grown older.)

So kudos to these reporters for writing a careful headline that stays true to the analysis.

I also found this video at FT that discussed the chart.

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This chart about Wimbledon players hits the Trifecta. It has an interesting – to some, surprising – message (Q). It demonstrates thoughtful processing and analysis of the data (D). And the visual design fits well with its intended message (V). (For a comprehensive guide to the Trifecta Checkup, see here.)